DRD 28: Spaced Repetition in Medical Learning: The Secret Tool for Productivity and Long-Term Retention

“The hardest part of learning is not understanding, it’s remembering.”

Why Traditional Learning Fails in Medicine

Medical colleges often focus on content overload—syllabi packed with complex topics, endless notes, and pressure to "finish the portion." As a result, most students are advised to memorize large chunks of information quickly. But here’s the problem:

• Even if you understand the concept deeply, you forget it after a few days or weeks.

• You revise randomly, and sometimes only right before exams.

• The brain, by nature, is wired to forget what it doesn’t use.

This is where Spaced Repetition comes in—an evidence-based learning technique that boosts productivity, retention, and confidence, especially in high-pressure fields like medicine.

Image courtesy: Wix

What is Spaced Repetition?

Spaced Repetition is a learning technique that involves reviewing information at increasing intervals over time. The goal is to time your revision just before you're about to forget it.

This method is based on the Forgetting Curve proposed by German psychologist Hermann Ebbinghaus. He discovered that memory retention drops dramatically over time unless we actively review what we’ve learned.

The Curve of Forgetting

Without review:

• After 1 day: You forget ~50%

• After 2 days: You forget ~70%

• After 6 days: You forget ~90%

With spaced reviews:

• You interrupt the forgetting curve, and memory becomes stronger and longer-lasting each time.

Image courtesy: AI

Scientific Backing: Why It Works

📚 Numerous studies back this up:

1. Cepeda et al., 2006 (Psychological Science) – A meta-analysis of over 254 experiments found spaced repetition significantly outperforms massed (crammed) learning.

2. Karpicke & Roediger, 2008 (Science Journal) – Retrieval-based learning with spacing improved long-term retention more than passive review.

3. Pashler et al., 2007 (Review of Educational Research) – Recommended spacing intervals depending on how long you want to remember something. Even 24-48 hours between reviews can double retention.

   
   

The Science Behind the Magic:

Numerous studies in cognitive psychology and neuroscience have validated the effectiveness of spaced repetition. Here's a glimpse into the underlying mechanisms:

• Active Recall: Each time you attempt to retrieve information from memory, you strengthen the neural connections associated with that information. This process of active recall is far more effective for long-term retention than passive review.

• Desirable Difficulty: Spacing out repetitions introduces a degree of "desirable difficulty." Recalling information just as you're about to forget it requires more cognitive effort, which paradoxically leads to stronger and more durable memories.

• Metacognition: Spaced repetition encourages metacognition – thinking about your own thinking and learning. You become more aware of what you know and what you need to review, leading to more efficient and targeted studying.

• Long-Term Potentiation (LTP): At a cellular level, spaced repetition facilitates long-term potentiation, a process that strengthens the synaptic connections between neurons, making it easier for those neurons to fire together in the future, thus solidifying memories.

How to Use Spaced Repetition in Medical Learning

Here’s how to practically apply it as a medical student or doctor:

1. Use Spaced Repetition Software (SRS)

• Anki: Free, open-source, and based on the SM-2 algorithm. Highly customizable.

• Brainscape, RemNote, and Quizlet also support spaced repetition.

• Create short flashcards or use shared decks like:

  • AnKing (USMLE/PG prep)

  • Zanki

  • Pathoma & Sketchy decks

2. Follow Optimal Spacing Intervals

A common schedule used in Anki:

• Day 0 (Initial learning)

• Day 1 (First review)

• Day 3 (Second review)

• Day 7 (Third review)

• Day 14, 30, 60… (Increasing gaps)

Adjust based on:

• Topic difficulty: Pharmacology may need more frequent reviews than Anatomy.

• Relevance: Prioritize high-yield or clinically important material.

3. Keep Cards Simple

Avoid turning entire textbook paragraphs into flashcards. Use:

• Active recall: “What is the mechanism of action of heparin?”

• Cloze deletions (fill-in-the-blank)

• Use images or diagrams (especially for Anatomy and Microbiology)

4. Integrate with Clinical Practice

Spaced repetition isn’t just for exams. Use it to remember:

• ACLS protocols

• Drug dosages

• Diagnostic criteria (ex: SIRS, DKA, HLH)

Image courtesy: Wix

What You Should Remember When Using Spaced Repetition

✅ Be consistent – Just 20–30 minutes daily is enough to maintain progress.

✅ Don’t overload yourself – Set a limit on the number of new cards per day.

✅ Understand first, memorize later – This technique boosts memory, not comprehension.

✅ Customize – Create your own decks tailored to your curriculum and patient cases.

✅ Sync across devices – Most apps let you review cards during commute, break time, etc.

Why This Matters for Busy Doctors

Even after MBBS or MD, doctors face constant learning—new guidelines, drugs, protocols. Spaced repetition helps in:

• Staying updated

• Passing licensing exams (like MRCP, PLAB)

• Teaching students effectively

If you're too busy to create cards, start with premade decks and slowly add your own from cases and ward experiences.

Final Thoughts

Spaced repetition is a game-changer, especially in the demanding world of medicine. It’s not magic, but a scientifically-backed, practical strategy to stay sharp without burning out.

It helps you make the most of your time, boosts your productivity, and ensures that you’re not just cramming for the next exam—but building a solid foundation for lifelong clinical excellence.

Ready to Try?

Start small. Download Anki. Make 10 cards today.

Stick to it for a week.

You’ll be surprised at how much you remember, even when you don’t try hard.